| NPI | 1104846724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401200) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT 145622) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 517976-1) | |
| 363L00000X Nurse Practitioner (Licence: CT 7304) | |
| 363LC1500X Nurse Practitioner, Community Health (Licence: NY 320051) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2018-07-23 |