| NPI | 1376929620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2015019053) |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2015-08-09 |
| Last Update Date | 2015-08-09 |