| NPI | 1447498738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401455) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 18499) |
| 183500000X Pharmacist (Licence: NY 050124) | |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2012-01-30 |