NPI | 1710192588 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2016024375) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 0221025253) |
363A00000X Physician Assistant | |
Enumeration Date | 2007-05-14 |
Last Update Date | 2023-03-01 |