| NPI | 1700408721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403137) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 711374) |
| Enumeration Date | 2020-05-13 |
| Last Update Date | 2021-01-20 |