| NPI | 1740059146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065873) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: NC BACB1074868) |
| 146N00000X Emergency Medical Technician, Basic (Licence: PA PA0889797) | |
| 363A00000X Physician Assistant (Licence: PA OA006974) | |
| 363A00000X Physician Assistant (Licence: NC 0010-14070) | |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2024-12-09 |