| NPI | 1376066415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405118) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 340611) |
| Enumeration Date | 2017-07-20 |
| Last Update Date | 2024-05-23 |