| NPI | 1679093827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 342520) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 722523) |
| 363L00000X Nurse Practitioner (Licence: NY 342520) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405600) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2024-07-08 |