| NPI | 1023673183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-12736) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2019-05-04 |
| Last Update Date | 2022-10-25 |