| NPI | 1225599095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: FL ND8449) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: FL AL3650) |
| Enumeration Date | 2019-03-26 |
| Last Update Date | 2019-03-26 |