| NPI | 1174108666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 12945) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2021-03-16 |
| Last Update Date | 2025-04-06 |