| NPI | 1184915720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA065910) |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133V00000X Dietitian, Registered | |
| Enumeration Date | 2011-05-01 |
| Last Update Date | 2024-11-28 |