| NPI | 1407146558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403211-01) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY F403211-01) |
| Enumeration Date | 2011-04-11 |
| Last Update Date | 2021-02-24 |