| NPI | 1316599863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402734) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 402734) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2024-04-01 |