| NPI | 1508586207 |
|---|---|
| Former Name | SARAH ELIZABTH WALLY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: CT 002064) |
| Enumeration Date | 2022-09-01 |
| Last Update Date | 2022-09-01 |