| NPI | 1164745584 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402390) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22-605331) |
| Enumeration Date | 2010-03-12 |
| Last Update Date | 2018-06-28 |