NPI | 1871125484 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 106S00000X Behavior Technician (Licence: AR 19-106760) |
Enumeration Date | 2020-02-11 |
Last Update Date | 2024-06-24 |