| NPI | 1023564721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA 998341) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: DN004293) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2016-09-01 |