| NPI | 1376996470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307778) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405550) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: UT 10132) | |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2024-12-19 |