| NPI | 1225580681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11029805) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2024-01-11 |