| NPI | 1700219680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405537-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 627780-1) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2024-06-18 |