| NPI | 1083071476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 245221) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2019-01-04 |