| NPI | 1770936536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WY 215) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OH LD7998) |
| Enumeration Date | 2016-07-18 |
| Last Update Date | 2018-01-11 |