| NPI | 1699108589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MI 86013124) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WV 931) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2017-10-12 |