| NPI | 1669667168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AZ 6322) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AZ 960531) |
| Enumeration Date | 2007-09-09 |
| Last Update Date | 2017-12-12 |