| NPI | 1275356206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F406770-01) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 29243) |
| Enumeration Date | 2024-11-07 |
| Last Update Date | 2026-05-05 |