| NPI | 1639569874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-09359) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L005880) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2024-04-09 |