| NPI | 1730482324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA152640) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR 914238) |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2021-11-02 |