| NPI | 1336360270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: MD DX4649) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C0001051) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2019-09-11 |