| NPI | 1174800700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: FL PN1174971)  | 
| Additional Taxonomies | 133N00000X Nutritionist | 
| Enumeration Date | 2011-11-10 | 
| Last Update Date | 2011-11-10 |