| NPI | 1396622783 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX4224) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2025-08-19 |
| Last Update Date | 2025-08-19 |