| NPI | 1164149712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 010893) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: NY 010893) |
| Enumeration Date | 2022-10-25 |
| Last Update Date | 2022-10-25 |