| NPI | 1013597715 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: NC 0010-14440) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-04-08 |
| Last Update Date | 2024-10-03 |