| NPI | 1295046779 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 1747) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA 1747) |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2010-06-29 |