| NPI | 1255360848 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: PR 10197) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: PR 1217) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-10-11 |