| NPI | 1952789638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 3074) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: SC LRD.1256) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2018-10-09 |