| NPI | 1679065882 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CT 23.006776) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2018-06-04 |
| Last Update Date | 2024-10-16 |