| NPI | 1972915387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402191-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F306884-1) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2020-01-07 |