| NPI | 1992940290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA055081) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: PA DN001558) |
| 133V00000X Dietitian, Registered (Licence: RD822188) | |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2012-02-06 |