| NPI | 1700504339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404337) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 726989-1) |
| 207R00000X Internal Medicine (Licence: NY 404337) | |
| Enumeration Date | 2022-08-19 |
| Last Update Date | 2023-07-22 |