| NPI | 1235785528 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA68302) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-08-13 |
| Last Update Date | 2026-06-29 |