NPI | 1629737044 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405047) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 795414) |
Enumeration Date | 2021-12-13 |
Last Update Date | 2023-07-31 |