| NPI | 1558877415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MA 292965) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA BACB401629) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2022-08-19 |