| NPI | 1740555622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403603-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 605544-1) |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2021-11-10 |