| NPI | 1639704612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: TX 789790498) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: TX 19-108228) |
| Enumeration Date | 2020-03-10 |
| Last Update Date | 2025-04-25 |