| NPI | 1063718633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AR PA-705) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AR 1121) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2022-02-11 |