| NPI | 1295224079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ACN1523)  | 
| Additional Taxonomies | 106S00000X Behavior Technician | 
| 2081H0002X Physical Medicine & Rehabilitation, Hospice and Palliative Medicine (Licence: FL TRN37416)  | |
| Enumeration Date | 2018-05-07 | 
| Last Update Date | 2024-05-14 |