| NPI | 1972943322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: MD R118740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NY F337810) |
| Enumeration Date | 2013-06-30 |
| Last Update Date | 2019-08-30 |