| NPI | 1598188088 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: RI 00733) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3433) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2022-10-19 |