| NPI | 1467954644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8639) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AZ 86026218) |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2021-11-20 |