| NPI | 1659631497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L002796) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX2721) |
| Enumeration Date | 2012-05-28 |
| Last Update Date | 2023-12-14 |