NPI | 1811393069 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402039) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22616357) |
Enumeration Date | 2014-11-17 |
Last Update Date | 2018-12-17 |