| NPI | 1861747198 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403764-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 656495) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2022-06-06 |