| NPI | 1790315885 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403487) | 
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: NY 780282) | 
| Enumeration Date | 2020-01-17 | 
| Last Update Date | 2021-10-21 |