| NPI | 1457820763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95016894) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-11-15 |
| Last Update Date | 2021-04-22 |