| NPI | 1962010272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 402925) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 709741) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 345604) | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-09-14 |