| NPI | 1659778561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403311-01) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305546-1) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2024-02-16 |