| NPI | 1548754567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 402570) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F342742) |
| Enumeration Date | 2018-06-22 |
| Last Update Date | 2020-12-30 |