| NPI | 1902679483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 407140) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 692082) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2025-07-30 |