| NPI | 1619565660 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MD R278322) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-01-05 |
| Last Update Date | 2026-09-10 |