| NPI | 1679156764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 839145) |
| Additional Taxonomies | 133VN1101X Dietitian, Registered Nutrition, Gerontological (Licence: FL ND11169) |
| Enumeration Date | 2021-05-05 |
| Last Update Date | 2024-05-11 |