NPI | 1376015941 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA3174) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-12-20 |
Last Update Date | 2023-04-03 |