| NPI | 1003453481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GU PA-141) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 86017372) |
| Enumeration Date | 2019-12-05 |
| Last Update Date | 2024-09-16 |