| NPI | 1972269876 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 8121-23) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 3755-29) |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2024-12-13 |