| NPI | 1073988440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1440) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3658) |
| Enumeration Date | 2015-12-10 |
| Last Update Date | 2022-04-04 |