| NPI | 1164652129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 582245) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F407373-01) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2026-01-08 |