| NPI | 1376196550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA PA61608960) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WA 61005182) |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2024-10-22 |