| NPI | 1215243233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KS 000357) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2001011603) |
| Enumeration Date | 2010-08-27 |
| Last Update Date | 2010-08-27 |