| NPI | 1790519072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406430) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 794920) |
| Enumeration Date | 2024-08-28 |
| Last Update Date | 2024-10-08 |