| NPI | 1336583913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 306435) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402798) |
| 275N00000X Medicare Defined Swing Bed Unit (Licence: NY F306435-1) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2021-09-27 |