| NPI | 1568971794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: HI AMD-1192) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-17-38889) |
| Enumeration Date | 2017-09-19 |
| Last Update Date | 2023-01-12 |