| NPI | 1750167763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN5265240) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-09-05 |
| Last Update Date | 2025-07-31 |