| NPI | 1366951261 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: 1206904) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86081622) |
| Enumeration Date | 2017-09-22 |
| Last Update Date | 2023-12-03 |