| NPI | 1659775617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: SC 19016) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: SC 19016) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: SC 19016) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403105-01) | |
| Enumeration Date | 2014-10-20 |
| Last Update Date | 2022-12-03 |