| NPI | 1982010054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F401923-1) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 6737541) |
| Enumeration Date | 2014-07-09 |
| Last Update Date | 2016-05-03 |