| NPI | 1497254726 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86019606) | 
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: ALPP-210161) | 
| Enumeration Date | 2018-02-01 | 
| Last Update Date | 2018-02-01 |