| NPI | 1962572669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F400090-1) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY f400090) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F301572-1) | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2022-08-08 |