| NPI | 1932742574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404708) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 781063) |
| 163WP0808X Registered Nurse, Psych/Mental Health (Licence: NY 781063) | |
| Enumeration Date | 2019-10-28 |
| Last Update Date | 2023-02-20 |