| NPI | 1578929659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402301) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 706501) |
| 363L00000X Nurse Practitioner (Licence: NY 402301) | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2022-05-17 |