NPI | 1740282458 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 2961972) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 1-21-54618) |
Enumeration Date | 2005-08-12 |
Last Update Date | 2021-11-15 |