| NPI | 1639955537 |
|---|---|
| Former Name | LILLYANNA GRADY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86131551) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MA LDN4982) |
| Enumeration Date | 2023-09-06 |
| Last Update Date | 2023-09-06 |