| NPI | 1902258338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403020) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 624165) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 341586) | |
| Enumeration Date | 2016-07-11 |
| Last Update Date | 2024-06-18 |