| NPI | 1134573538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA AP61463795) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-04-21 |
| Last Update Date | 2023-08-15 |