| NPI | 1639618994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0017759) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2022-05-10 |