| NPI | 1639901705 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 13851) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| 133V00000X Dietitian, Registered (Licence: GA 13851) | |
| Enumeration Date | 2024-08-16 |
| Last Update Date | 2026-05-07 |