| NPI | 1063760247 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID 637) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR 10148795) |
| 133V00000X Dietitian, Registered (Licence: MA 3326) | |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2012-08-20 |