| NPI | 1780155382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F405403-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 692965-1) |
| Enumeration Date | 2018-12-09 |
| Last Update Date | 2023-11-08 |