| NPI | 1952603557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY F336963-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 580524) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F403720-01) | |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2023-09-13 |