| NPI | 1629699491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11021206) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst (Licence: FL 0-21-13304) |
| Enumeration Date | 2020-05-02 |
| Last Update Date | 2023-03-06 |