| NPI | 1639810872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403533-01) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NY 403533) |
| Enumeration Date | 2022-04-03 |
| Last Update Date | 2025-08-22 |