| NPI | 1538524996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402101-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 558878) |
| Enumeration Date | 2015-12-29 |
| Last Update Date | 2016-10-12 |