| NPI | 1689117582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: FL 9411205) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-20-139326) |
| Enumeration Date | 2016-11-24 |
| Last Update Date | 2024-03-06 |