| NPI | 1841304656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY F400521-01) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400521-1) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-05-01 |