| NPI | 1942827878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9119273) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2024-12-04 |