| 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 |