| NPI | 1063821957 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401757) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 641150) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2021-08-10 |