| NPI | 1700911724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR 658) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 082010492rn) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2012-04-04 |