| NPI | 1477114072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402715-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 770949-01) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-07-08 |