| NPI | 1295962454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402505) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY f335902-1) |
| Enumeration Date | 2009-06-16 |
| Last Update Date | 2020-08-10 |