NPI | 1922373398 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402724) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 653532-1) |
Enumeration Date | 2012-03-17 |
Last Update Date | 2019-09-13 |