| NPI | 1407961386 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401533) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY F303125 / 436475) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2021-04-05 |