| NPI | 1356671820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: VA 0110004161) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 606641) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2013-06-12 |