| NPI | 1629422324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CT 006566) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 001280) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2024-05-21 |