| NPI | 1457850380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601011749) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| 247200000X | |
| Enumeration Date | 2018-02-06 |
| Last Update Date | 2023-07-09 |