NPI | 1699172049 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MT 21049) |
Enumeration Date | 2014-12-01 |
Last Update Date | 2023-11-09 |