| NPI | 1811062037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: MA 849104) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 849104) |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: MA 849104) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2007-07-08 |