NPI | 1922457514 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9305079) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: BCBA-1-24-78442) |
Enumeration Date | 2016-06-06 |
Last Update Date | 2025-05-02 |