| NPI | 1265998801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024442) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-70812) |
| 163W00000X Registered Nurse (Licence: FL RN9551811) | |
| Enumeration Date | 2019-02-19 |
| Last Update Date | 2023-05-22 |