| NPI | 1699188078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404100) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 341820) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9196852) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2024-04-17 |