| NPI | 1114177227 |
|---|---|
| Former Name | AMY BOLTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA DN001274) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: PA DN001274) |
| Enumeration Date | 2008-09-25 |
| Last Update Date | 2016-01-12 |