| NPI | 1710508270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: 1202357) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86026279) |
| Enumeration Date | 2020-05-06 |
| Last Update Date | 2022-12-28 |