| NPI | 1790906238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401998) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 301872) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 301872) | |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-05-26 |