| NPI | 1154965440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024410) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-10-30 |
| Last Update Date | 2023-03-22 |