| NPI | 1396563797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106S00000X Behavior Technician (Licence: FL RBT-24-399527) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PR 2276) |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2024-12-14 |