| NPI | 1336491299 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NJ 0101111) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NJ 21210296) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2018-09-15 |