| NPI | 1619594512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VT 074.0134254) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 2019-001165-NU-R) |
| Enumeration Date | 2020-06-26 |
| Last Update Date | 2021-12-02 |