| NPI | 1215694104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405446-01) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F11210411) |
| Enumeration Date | 2021-11-26 |
| Last Update Date | 2024-07-19 |