| NPI | 1912519059 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403078-01) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY F403078) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403078) | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2022-12-28 |