| NPI | 1205301314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 009478) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86059542) |
| Enumeration Date | 2018-10-05 |
| Last Update Date | 2018-10-05 |