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 |