| NPI | 1083950646 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402065-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 603046) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306230) | |
| Enumeration Date | 2012-12-28 |
| Last Update Date | 2021-05-18 |