| NPI | 1003255670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404828) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337873-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL 11009274) | |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2023-07-17 |