| NPI | 1205014842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 509598 dup) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 40401438) |
| Enumeration Date | 2008-02-06 |
| Last Update Date | 2020-11-10 |