| NPI | 1104157882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 344226) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 631632) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404072) | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2022-11-03 |