| NPI | 1033717764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403414-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720493) |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2021-04-01 |