| 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 |