| NPI | 1619411220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MA 4112) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NH 0795) |
| Enumeration Date | 2016-12-15 |
| Last Update Date | 2016-12-15 |