| NPI | 1265981617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 59129) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 1092791) |
| Enumeration Date | 2016-09-27 |
| Last Update Date | 2024-01-25 |