| NPI | 1861987158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND 202914) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: ND RBT-18-59383) |
| Enumeration Date | 2018-06-28 |
| Last Update Date | 2025-07-18 |