| NPI | 1689190969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402807) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 545039) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 307698) | |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2019-11-22 |