| NPI | 1811696560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 406069) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 767792) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2024-10-31 |