NPI | 1730648155 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402696) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 9725362) |
Enumeration Date | 2019-03-15 |
Last Update Date | 2023-04-05 |