| NPI | 1962048744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367H00000X Anesthesiologist Assistant (Licence: 789790519) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2025-06-04 |