| NPI | 1811883663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-15939) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: SC 3446) |
| 133V00000X Dietitian, Registered (Licence: NC L004872) | |
| 133V00000X Dietitian, Registered (Licence: OR LD-D-10261746) | |
| Enumeration Date | 2025-06-17 |
| Last Update Date | 2025-12-05 |