| NPI | 1558779199 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: DC PA200001507) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: DC PA200001507) |
| 133V00000X Dietitian, Registered (Licence: NC L004347) | |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-06-28 |