| NPI | 1700161593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07545) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L003725) |
| Enumeration Date | 2011-10-12 |
| Last Update Date | 2022-07-21 |