| NPI | 1366948549 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86070843) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX4529) |
| Enumeration Date | 2018-04-05 |
| Last Update Date | 2018-11-02 |