| NPI | 1215103270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: MD DX3854) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: DE J3-0000318) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MD A0000083) | |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2022-04-07 |