| NPI | 1962070995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 103K00000X Behavior Analyst (Licence: NY 1364201191) |
| 174400000X Specialist | |
| Enumeration Date | 2021-06-15 |
| Last Update Date | 2023-04-18 |