| NPI | 1841725520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601010693) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2022-06-29 |