NPI | 1922568708 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-2815) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ID D-1091) |
Enumeration Date | 2019-03-20 |
Last Update Date | 2024-07-22 |