| NPI | 1720319189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL 9111018) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH LD6064) |
| Enumeration Date | 2010-01-26 |
| Last Update Date | 2019-06-10 |