| NPI | 1316495542 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401876)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 549041)  | 
| Enumeration Date | 2016-09-16 | 
| Last Update Date | 2018-10-02 |