| NPI | 1770930448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11018601) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 106S00000X Behavior Technician | |
| 247200000X | |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2022-03-15 |