| NPI | 1275003790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 11000305) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 24-334407) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: FL 11000305) | |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2024-06-19 |