| NPI | 1972883429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VA 011004742) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2011-08-27 |
| Last Update Date | 2016-11-30 |