| NPI | 1104217504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KY 2470) |
| Enumeration Date | 2015-02-07 |
| Last Update Date | 2026-03-29 |