| NPI | 1306215819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: MA 3559) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3559) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |