| NPI | 1336417047 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL nd7755) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: FL pta21220) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2026-03-23 |