| NPI | 1053793158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND8742) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: VA L-104867) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2019-09-05 |