| NPI | 1629565759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI60841607) | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86084920) | 
| Enumeration Date | 2018-04-14 | 
| Last Update Date | 2025-10-06 |