| NPI | 1104496801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403597) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 676673) |
| Enumeration Date | 2021-06-26 |
| Last Update Date | 2021-08-20 |