| NPI | 1265600621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-06856) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NM LD-0684) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2023-05-31 |