| NPI | 1346000189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601012340) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-09-26 |