| NPI | 1982139804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 8822) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2017-04-28 |
| Last Update Date | 2022-01-25 |