| NPI | 1194411447 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MT MED-NUT-LIC-125402) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: L-21954) |
| Enumeration Date | 2023-04-11 |
| Last Update Date | 2025-01-03 |