| NPI | 1679093868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11023169) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2023-05-05 |