| NPI | 1154809663 |
|---|---|
| Former Name | JESSICA HUCKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 1102871) |
| Additional Taxonomies | 136A00000X Dietetic Technician, Registered |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2020-11-03 |