| NPI | 1063573053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401540) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306291-1) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ00124700) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2025-05-29 |