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 |