| NPI | 1659664167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KS 000215) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered Nutrition, Pediatric (Licence: KS 000215) |
| 133VN1006X Dietitian, Registered Nutrition, Metabolic (Licence: KS 000215) | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2021-05-10 |