| NPI | 1164446423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NC MANN-W9ZDK) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 302028) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: NY 380861) | |
| 163W00000X Registered Nurse (Licence: NY 380671) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407393) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2025-11-21 |