| NPI | 1710100292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NE 439) |
| Additional Taxonomies | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: NE 439) |
| 261QC0050X Clinic/Center, Critical Access Hospital (Licence: NE 439) | |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2011-04-18 |