| NPI | 1366975500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TN 3193) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 3193) |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: TN 3193) | |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2020-04-01 |