| NPI | 1548715618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WA 1213133) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CO 1104717) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2024-11-12 |