| NPI | 1902456387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY F402742-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 678215) |
| Enumeration Date | 2019-09-17 |
| Last Update Date | 2023-07-18 |