| NPI | 1710380597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA 1064141) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: PA DN005463) |
| Enumeration Date | 2014-10-07 |
| Last Update Date | 2014-10-07 |