| NPI | 1568080885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 010564) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86054063) |
| Enumeration Date | 2020-07-13 |
| Last Update Date | 2021-10-17 |