| NPI | 1407313083 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TN 38607) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2025-05-06 |