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 |