| NPI | 1861512501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103K00000X Behavior Analyst (Licence: 1-04-1782) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2012-11-27 |