| NPI | 1184999344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 344753) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687063) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 344753) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405889) | |
| Enumeration Date | 2012-03-20 |
| Last Update Date | 2024-10-18 |