| NPI | 1215338975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1101X Dietitian, Registered, Nutrition, Gerontological (Licence: WY 150) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WY 150) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2019-11-26 |