| NPI | 1578670741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401075) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401075) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 340084-1) | |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2011-10-25 |