| NPI | 1790069300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402845) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 640570) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2020-01-28 |