| NPI | 1275535890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 04198) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IA 00000) |
| Enumeration Date | 2005-08-12 |
| Last Update Date | 2013-08-14 |