| NPI | 1679958672 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 166139) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2015-07-21 |
| Last Update Date | 2018-03-17 |