| NPI | 1952964405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: NY 405980) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2024-08-15 |