| NPI | 1669960886 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD004733) |
| Enumeration Date | 2018-04-23 |
| Last Update Date | 2023-10-19 |