| NPI | 1225688112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13737) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NC RBT-19-97908) |
| Enumeration Date | 2019-09-12 |
| Last Update Date | 2024-01-26 |