| NPI | 1306580790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11044057) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-04-22 |
| Last Update Date | 2026-01-09 |