| NPI | 1518503382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 5332) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2019-11-26 |
| Last Update Date | 2022-01-31 |