NPI | 1184388530 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL F06250430) |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-189527) |
Enumeration Date | 2021-10-22 |
Last Update Date | 2025-07-30 |