| NPI | 1194281444 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402705) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 001782) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2023-02-01 |