| NPI | 1043428956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA003974) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058395) |
| 133V00000X Dietitian, Registered (Licence: PA DN005131) | |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2022-05-31 |