| NPI | 1013142405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-03826) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L003778) |
| 133V00000X Dietitian, Registered (Licence: WA 60078721) | |
| 363A00000X Physician Assistant (Licence: NC 0010-03826) | |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2023-12-31 |