| NPI | 1154878023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 403787-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 688455) |
| 363LF0000X Nurse Practitioner Family (Licence: NY 340825) | |
| Enumeration Date | 2016-09-08 |
| Last Update Date | 2021-10-28 |