| NPI | 1104579879 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND10592)  | 
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: FL ND10592)  | 
| Enumeration Date | 2022-02-01 | 
| Last Update Date | 2022-08-17 |