| NPI | 1033888664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA MD-54963) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NM RS2022-0370) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2025-12-10 |