| NPI | 1245789841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406000) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 30307966) |
| Enumeration Date | 2016-09-25 |
| Last Update Date | 2024-08-21 |