| NPI | 1063042745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9483399) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-106686) |
| Enumeration Date | 2020-01-22 |
| Last Update Date | 2023-04-04 |