| NPI | 1578822003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401273) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 401273) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2023-07-07 |