| NPI | 1164769030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404814) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ 26NJ14844200) |
| 163W00000X Registered Nurse (Licence: NY 794434) | |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2025-09-07 |