| NPI | 1689927808 |
|---|---|
| Former Name | IVY MARIE KULAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TN 1043566) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: TN 2542) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2022-08-16 |