| NPI | 1417422395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405544) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 720868) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: NY F348863-01) | |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2024-06-03 |