| NPI | 1235455742 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH L6525) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: OH F78220) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2010-04-09 |