| 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 |