| NPI | 1760837090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: MI 4703065929) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-04-23 |
| Last Update Date | 2016-04-23 |