| NPI | 1104449255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403139) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 721142-1) |
| Enumeration Date | 2020-05-24 |
| Last Update Date | 2020-10-20 |