| NPI | 1861691792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 0034071) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered Nutrition, Metabolic (Licence: NY 002837-1) |
| Enumeration Date | 2007-07-11 |
| Last Update Date | 2007-07-11 |