| NPI | 1437290749 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH 8034) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 2119) |
| Enumeration Date | 2007-02-09 |
| Last Update Date | 2018-06-05 |