| NPI | 1619648862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KS 3149) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: MD A5545) |
| 133V00000X Dietitian, Registered (Licence: MD DX6724) | |
| Enumeration Date | 2021-09-27 |
| Last Update Date | 2024-10-09 |