| NPI | 1124385885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 2590) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OK 1841) |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2016-02-03 |