| NPI | 1366963290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 729947) |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-05-12 |