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 |