| NPI | 1508147208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F404553-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 643262-1) |
| Enumeration Date | 2011-09-08 |
| Last Update Date | 2023-01-06 |