| NPI | 1881081719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA 5350) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MA 5350) |
| 133V00000X Dietitian, Registered (Licence: MA 3020) | |
| Enumeration Date | 2015-04-17 |
| Last Update Date | 2018-03-17 |