| NPI | 1952967176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-14257) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: FL RBT-18-60187) |
| Enumeration Date | 2019-05-13 |
| Last Update Date | 2024-11-11 |