| NPI | 1639580301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F40356601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 584357) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2024-04-02 |