| NPI | 1841859709 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2024007424) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 86148257) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2024-04-23 |