| NPI | 1235620675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC PA5216) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA 17-40748) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2024-04-10 |