| NPI | 1730622051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX4101) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WV 1158) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2025-01-07 |