| NPI | 1699048579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12099180-1206) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2022-02-23 |