| NPI | 1790312197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WV 1160) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX4337) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |