| NPI | 1275192882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: MI 4704389499) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-06-07 |
| Last Update Date | 2026-05-01 |