| NPI | 1164897864 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 001009493) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX3884) |
| Enumeration Date | 2015-12-07 |
| Last Update Date | 2019-11-23 |