| NPI | 1275025090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11049771) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 1744149) |
| Enumeration Date | 2018-06-06 |
| Last Update Date | 2026-08-14 |