| NPI | 1962857540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11024379) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2016-05-02 |
| Last Update Date | 2023-10-05 |