| NPI | 1760698260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WN1003X Registered Nurse, Nutrition Support (Licence: IL 041-230219) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 166.000713) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2017-03-09 |