| NPI | 1750682928 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI60582627)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 997435)  | 
| Enumeration Date | 2010-11-04 | 
| Last Update Date | 2016-03-21 |