| NPI | 1730644030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA66571) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA RBT-19-76888) |
| Enumeration Date | 2019-01-31 |
| Last Update Date | 2026-09-04 |