NPI | 1629587373 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8802) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA 62605) |
106S00000X Behavior Technician (Licence: CA RBT-17-39209) | |
Enumeration Date | 2017-09-26 |
Last Update Date | 2023-06-22 |