| NPI | 1669139655 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WI 86172573)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: SC 2155)  | 
| Enumeration Date | 2021-11-24 | 
| Last Update Date | 2021-11-24 |