| NPI | 1053088542 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 282616) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH 86076991) |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2024-05-13 |