| NPI | 1346902863 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 11221) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: IL 21-188148) |
| Enumeration Date | 2021-10-12 |
| Last Update Date | 2025-10-23 |