| NPI | 1073650636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU60816855) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00022615) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2018-10-29 |