| NPI | 1043568223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403170-01) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 310828) |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2020-10-20 |