| NPI | 1629614912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86010488) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 3491) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |