| NPI | 1831615780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11030558) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2024-02-07 |