| NPI | 1568959633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 86073589) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 4857) |
| Enumeration Date | 2018-04-15 |
| Last Update Date | 2022-10-07 |