| NPI | 1649780297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404759) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6693231) |
| Enumeration Date | 2017-10-10 |
| Last Update Date | 2023-04-29 |