| NPI | 1164986071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: GA LD005202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN277983) |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2019-01-24 |