| 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 |