| NPI | 1295350833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11032659) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL 20-122603) |
| Enumeration Date | 2020-06-09 |
| Last Update Date | 2024-05-06 |