| NPI | 1891213195 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT83578) |
| Enumeration Date | 2017-09-07 |
| Last Update Date | 2022-04-05 |