| NPI | 1740836329 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL 7404) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL 7404) |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: FL 7404) | |
| 207QA0505X Family Medicine, Adult Medicine (Licence: FL 7404) | |
| Enumeration Date | 2019-08-10 |
| Last Update Date | 2019-08-10 |