| NPI | 1225559164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11970) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-06-30 |
| Last Update Date | 2022-02-09 |