| NPI | 1164132213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 2024030208) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 857480) |
| Enumeration Date | 2022-11-30 |
| Last Update Date | 2024-11-06 |