| NPI | 1528686185 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F404217-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 646076) |
| Enumeration Date | 2020-07-10 |
| Last Update Date | 2022-10-03 |