| NPI | 1760009211 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403112) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 668814) |
| Enumeration Date | 2020-07-01 |
| Last Update Date | 2020-08-05 |