| NPI | 1659892495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402398-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 22-719661) |
| Enumeration Date | 2017-07-02 |
| Last Update Date | 2018-06-26 |