| NPI | 1205206893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407618) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F344400) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN307928) | |
| Enumeration Date | 2015-09-25 |
| Last Update Date | 2025-10-21 |