| NPI | 1801267976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403621) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 1578240) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 621471) | |
| Enumeration Date | 2015-10-14 |
| Last Update Date | 2021-09-14 |