| NPI | 1366842593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9143) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L004348) |
| 133V00000X Dietitian, Registered (Licence: MA 3587) | |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2023-08-09 |