| NPI | 1679003354 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86032477) | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: LA 2580) | 
| Enumeration Date | 2017-06-15 | 
| Last Update Date | 2017-06-15 |