| NPI | 1104477280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405448) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F309211) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2024-04-12 |