| NPI | 1851864516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education |
| 2255A2300X Specialist/Technologist Athletic Trainer | |
| Enumeration Date | 2019-01-05 |
| Last Update Date | 2019-01-05 |