| NPI | 1730405622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 40-401770) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 620964) |
| Enumeration Date | 2010-04-16 |
| Last Update Date | 2017-06-09 |