| NPI | 1063772176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 3044) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered Nutrition, Pediatric (Licence: MN 3044) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2012-05-22 |