NPI | 1073889325 |
---|---|
Former Name | THEA ROBERTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 999481) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR LD-D-10185772) |
Enumeration Date | 2012-03-30 |
Last Update Date | 2021-11-20 |