| NPI | 1538436670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA52487) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NV PA2351) |
| 363A00000X Physician Assistant (Licence: ME PA2308) | |
| 133V00000X Dietitian, Registered (Licence: MA 1102870) | |
| Enumeration Date | 2011-11-17 |
| Last Update Date | 2022-10-14 |