| NPI | 1841711132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA9233) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 4295) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2025-08-26 |