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