| NPI | 1821659194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009728) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX4403) |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2025-03-03 |