| NPI | 1972187839 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 403516) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 727162) |
| Enumeration Date | 2021-05-07 |
| Last Update Date | 2021-06-21 |