| NPI | 1588204390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402898) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 693069) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2020-01-27 |