| NPI | 1053741462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA.2583) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD003799) |
| 363AM0700X Physician Assistant, Medical (Licence: GA 10293) | |
| Enumeration Date | 2013-11-21 |
| Last Update Date | 2025-03-24 |