NPI | 1669636759 |
---|---|
Former Name | PEGGY MARIE KOUASSI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402204) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 242551-1) |
Enumeration Date | 2008-07-17 |
Last Update Date | 2019-12-31 |