| 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 | 2023-05-11 |