| NPI | 1548797194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404798-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 675250) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2024-08-29 |