| NPI | 1760835698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 118136) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2023-04-18 |