| NPI | 1700264314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ND PAC0779) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ND 0969) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2019-07-26 |