| NPI | 1730412784 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 001360) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 001360) |
| Enumeration Date | 2009-09-09 |
| Last Update Date | 2020-07-22 |