| NPI | 1003346974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402385) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NJ 26NR19200200) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2018-06-13 |