| NPI | 1992057475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 3148) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2022-05-23 |