| NPI | 1215116314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LA 3400) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 1108) |
| Enumeration Date | 2007-10-25 |
| Last Update Date | 2007-10-25 |