| NPI | 1245570282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402366) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 659896) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2019-01-09 |