| NPI | 1205447190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403503) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 779628) |
| 163WG0000X Registered Nurse, General Practice (Licence: NY 779628) | |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2022-07-21 |