| NPI | 1558302729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F3311701) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F4010451) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 3797211) | |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2011-04-05 |