| NPI | 1811594674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11008773) |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: FL 12149208) |
| Enumeration Date | 2020-10-05 |
| Last Update Date | 2021-04-29 |