| NPI | 1124629761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX5121) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 86116533) |
| Enumeration Date | 2020-11-02 |
| Last Update Date | 2020-11-05 |