| NPI | 1497227003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PT2021-075) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: RBT-18-68507) |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2021-11-02 |