| NPI | 1619014784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400759) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303621) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2019-06-10 |