| NPI | 1144671934 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402597) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 689982) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2019-10-21 |