| NPI | 1780081927 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 7436) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 1082925) |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2024-06-28 |