| NPI | 1861716763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403961) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 286446) |
| Enumeration Date | 2010-03-21 |
| Last Update Date | 2022-04-19 |