| NPI | 1821177718 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: WA NU00001733) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: WA MA00020299) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2007-07-08 |