| NPI | 1487375168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9121960) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-22-233799) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2026-07-10 |