| NPI | 1861112757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403565) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 668433) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-11-10 |