| NPI | 1386143451 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11031438) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: 17-44758) |
| Enumeration Date | 2018-02-05 |
| Last Update Date | 2026-03-16 |