| NPI | 1952040966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 404227) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: NY 404227) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2023-07-22 |