| NPI | 1245905090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: GA 14291) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2026-08-22 |