| NPI | 1700594652 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: HI PTA-745) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2022-11-09 |
| Last Update Date | 2026-03-16 |