NPI | 1548441694 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 008971-1) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 004737) |
Enumeration Date | 2007-11-16 |
Last Update Date | 2011-04-30 |