| NPI | 1639768542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: GA RBT-21-150117) |
| Enumeration Date | 2021-01-14 |
| Last Update Date | 2026-09-11 |