| NPI | 1023673183 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601013857) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-12736) |
| 106S00000X Behavior Technician | |
| Enumeration Date | 2019-05-04 |
| Last Update Date | 2026-06-08 |