| NPI | 1790952349 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006804) |
| Additional Taxonomies | 133VN1005X Dietitian, Registered, Nutrition, Renal |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2013-10-08 |