| NPI | 1477243392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F406141-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 738012) |
| Enumeration Date | 2023-05-12 |
| Last Update Date | 2024-09-07 |