| NPI | 1538405154 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-03932) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L003116) |
| Enumeration Date | 2012-12-31 |
| Last Update Date | 2012-12-31 |