| NPI | 1861349011 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: GA LD005502) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ND 1681) |
| 133V00000X Dietitian, Registered (Licence: MO 2025016573) | |
| 133V00000X Dietitian, Registered (Licence: WI 6241-29) | |
| Enumeration Date | 2026-03-16 |
| Last Update Date | 2026-03-16 |