| NPI | 1679225502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403968) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 357268) |
| Enumeration Date | 2022-01-21 |
| Last Update Date | 2026-02-13 |