| NPI | 1154575520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 9851) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: GA LD003056) |
| 133V00000X Dietitian, Registered (Licence: GA LD003056) | |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2022-09-16 |