| NPI | 1760007447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 403121-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 687146-01) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2020-08-25 |