| NPI | 1619648458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12797) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-21-185840) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2025-01-27 |