| NPI | 1629037015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT06571) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2011-03-15 |