| NPI | 1194546671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 6590) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 3595) |
| Enumeration Date | 2024-10-18 |
| Last Update Date | 2025-10-14 |