| NPI | 1790080893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID D-1022) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: ID MAS-403) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2023-02-21 |