| NPI | 1053664383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L003989) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: SC 1312) |
| Enumeration Date | 2012-10-24 |
| Last Update Date | 2016-03-07 |