| NPI | 1174357792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406910) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 274367) |
| 163W00000X Registered Nurse (Licence: NY 976214) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: TN 37219) | |
| Enumeration Date | 2024-08-27 |
| Last Update Date | 2025-06-30 |