| NPI | 1023876018 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110009915) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |