| NPI | 1962861690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA-1128) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: AL 2071) |
| Enumeration Date | 2016-02-23 |
| Last Update Date | 2016-02-23 |