| NPI | 1720474703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4449) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OK 2041) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2024-04-21 |