| NPI | 1821531765 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341029) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 641193) |
| 163W00000X Registered Nurse (Licence: MA 2343220) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 2343220) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MA 2343220) | |
| Enumeration Date | 2016-11-27 |
| Last Update Date | 2023-01-04 |