| NPI | 1730553140 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND4317) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: FL IMH11852) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2015-11-23 |