| NPI | 1659775450 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 1064077) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 007445) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2022-01-26 |