| NPI | 1366025322 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11033591) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-21-155719) |
| 163W00000X Registered Nurse (Licence: FL RN9598556) | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2024-09-16 |