| NPI | 1912751660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 405919) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 811120) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-09-11 |