| NPI | 1366933863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11034613) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 163W00000X Registered Nurse (Licence: FL 9596332) | |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2024-08-08 |