| NPI | 1609349315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MI 86073959) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2019-01-04 |
| Last Update Date | 2019-01-04 |