| NPI | 1649978008 |
|---|---|
| Former Name | MICHAELA JADE LONG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI61405696) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2023-02-15 |
| Last Update Date | 2024-10-29 |