| NPI | 1275980716 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KS 2018) |
| Enumeration Date | 2016-05-14 |
| Last Update Date | 2021-11-18 |