| NPI | 1639391691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 489639) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F40108-1) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2008-05-02 |