NPI | 1629553995 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86101200) |
Enumeration Date | 2018-10-02 |
Last Update Date | 2022-06-15 |