| NPI | 1003124660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341154) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405807) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341154-01) | |
| 163W00000X Registered Nurse (Licence: NY 580957) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2025-09-17 |