| NPI | 1619459518 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403475) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-142018) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2022-08-16 |