| NPI | 1467770792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID D-341) |
| 208000000X Pediatrics (Licence: ID PA-1502) | |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2018-08-04 |