| NPI | 1629265137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 002499) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 000746) |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2021-06-22 |