| NPI | 1639947971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 1049743) |
| Additional Taxonomies | 171400000X Health & Wellness Coach (Licence: AZ 354335640) |
| 174N00000X Lactation Consultant, Non-RN (Licence: CO L-49587) | |
| Enumeration Date | 2023-12-15 |
| Last Update Date | 2024-04-21 |