| NPI | 1750992608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: 1037743) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: L-75963) |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-13 |