| NPI | 1801157953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA64903) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 1069103) |
| 133V00000X Dietitian, Registered (Licence: OR LD-D-10245254) | |
| 133V00000X Dietitian, Registered (Licence: WA DI61576632) | |
| 363A00000X Physician Assistant (Licence: NM PA2017-0074) | |
| 133V00000X Dietitian, Registered (Licence: NM NDP-2023-0109) | |
| 363A00000X Physician Assistant (Licence: NY 033034-01) | |
| 363A00000X Physician Assistant (Licence: OR PA221723) | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2025-04-12 |