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 |