| NPI | 1760116768 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 721932)  | 
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: CA 21410548)  | 
| Enumeration Date | 2022-07-14 | 
| Last Update Date | 2022-07-14 |