| NPI | 1588205355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018570) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-19-77231) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2022-07-09 |