| NPI | 1578089769 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MA PA7967) |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2021-10-28 |