| NPI | 1255784831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9116142) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND 7795) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2022-07-09 |