| NPI | 1134261993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402160) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F335115-1) |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2019-08-14 |