| NPI | 1710307343 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403429-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 382232) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2021-05-03 |