| NPI | 1770822330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 13049) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ND 923) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2019-08-02 |