| NPI | 1336495142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 169952) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: AK 11169577) |
| Enumeration Date | 2012-07-30 |
| Last Update Date | 2022-07-26 |