| NPI | 1063736817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL PA891) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AL 1899) |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2016-08-04 |