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 |