| NPI | 1427463538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: TN 2528) |
| Additional Taxonomies | 133VN1005X Dietitian, Registered Nutrition, Renal (Licence: TN 0739) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2016-01-25 |