| NPI | 1659691962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403644) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 626792-1) |
| Enumeration Date | 2010-06-09 |
| Last Update Date | 2021-11-17 |