| NPI | 1740059146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14070) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: PA PA0889797) |
| 106S00000X Behavior Technician (Licence: NC BACB1074868) | |
| Enumeration Date | 2023-12-27 |
| Last Update Date | 2024-03-08 |