| NPI | 1063050540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA215797) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA DI60909406) |
| 133V00000X Dietitian, Registered (Licence: OR LD-D-10194800) | |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2023-07-07 |