| NPI | 1235497017 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1424) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: UT 7204080-4901) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2016-10-17 |