| NPI | 1417224064 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: RI LDN00707) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3220) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2020-11-17 |