| NPI | 1063756773 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401537-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 619984-1) |
| Enumeration Date | 2012-11-19 |
| Last Update Date | 2013-07-29 |