| NPI | 1760751754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401432-1) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 616586-1) |
| Enumeration Date | 2011-12-20 |
| Last Update Date | 2014-12-26 |