| NPI | 1174889125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403846) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 400887) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306249) | |
| Enumeration Date | 2012-04-04 |
| Last Update Date | 2022-12-21 |