| NPI | 1508335704 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR 10175520) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OR T1459) |
| Enumeration Date | 2018-11-16 |
| Last Update Date | 2018-11-16 |