| NPI | 1316556194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11031945) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL BACB420786) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2024-05-14 |