| NPI | 1972715969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NY 400313) |
| Additional Taxonomies | 364SP0809X Clinical Nurse Specialist, Psych/Mental Health, Adult (Licence: NY 400313) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2022-09-09 |