| NPI | 1134744295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11039437) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT20120259) |
| Enumeration Date | 2020-06-14 |
| Last Update Date | 2025-06-03 |