NPI | 1649780297 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404759) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6693231) |
Enumeration Date | 2017-10-10 |
Last Update Date | 2023-04-29 |