| NPI | 1639727597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402788) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NJ NJDCATEMP-025091) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL 104) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 239247) | |
| Enumeration Date | 2019-09-03 |
| Last Update Date | 2021-11-04 |