| NPI | 1639635766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F40378301) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NJ 25MZ00135600) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2022-02-02 |