| NPI | 1053404061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 331800) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 331800) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401277) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2023-04-11 |