| NPI | 1962754432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403617) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 726648) |
| 164W00000X Licensed Practical Nurse (Licence: NY 311096) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2022-01-10 |