| NPI | 1003674714 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA22399) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: OR ABA-IN-10241615) |
| Enumeration Date | 2024-03-07 |
| Last Update Date | 2025-02-18 |