| NPI | 1508955402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F401043) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 501436-1) |
| 363L00000X Nurse Practitioner (Licence: NY F401043) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-01-31 |