| NPI | 1912405051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 13565328-1206) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: UT 390200000X) | |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2024-03-04 |