| NPI | 1174521835 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 11013528) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F330681) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403062) | |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2022-02-01 |