| NPI | 1528636370 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310287) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: NY 790395) |
| 363AM0700X Physician Assistant, Medical (Licence: NY 310287) | |
| Enumeration Date | 2021-06-16 |
| Last Update Date | 2023-07-17 |