| NPI | 1801157953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NM PA2017-0074) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: 1069103) |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: 1069103) | |
| 133NN1002X Nutritionist, Nutrition, Education (Licence: 1069103) | |
| 133N00000X Nutritionist (Licence: 1069103) | |
| 133V00000X Dietitian, Registered (Licence: 1069103) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2024-03-18 |