| NPI | 1992080253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402790-01) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 485214-1) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2021-11-09 |