| NPI | 1710104401 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 2386) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ND 701) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2026-01-20 |