| NPI | 1639508161 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD D01520)  | 
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MD D01520)  | 
| 133NN1002X Nutritionist, Nutrition, Education (Licence: MD D01520)  | |
| Enumeration Date | 2013-11-05 | 
| Last Update Date | 2023-01-05 |