| NPI | 1154621795 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 123069) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KY 1004) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2018-03-17 |