| NPI | 1013383116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406523) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 609076) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307485) | |
| Enumeration Date | 2015-08-12 |
| Last Update Date | 2025-01-08 |