| NPI | 1144536533 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA059487) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA NU60172448) |
| 363A00000X Physician Assistant (Licence: NJ 25MP00373600) | |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2018-04-05 |