| NPI | 1295073096 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA DN004044) | 
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: PA RT003678) | 
| Enumeration Date | 2013-01-29 | 
| Last Update Date | 2025-07-16 |