| NPI | 1578816484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9905) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2022-08-05 |