| NPI | 1669954087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: NY 757284) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402516) |
| Enumeration Date | 2018-09-01 |
| Last Update Date | 2021-10-26 |