| NPI | 1780178814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2113) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID D-935) |
| Enumeration Date | 2018-06-21 |
| Last Update Date | 2022-03-07 |