| NPI | 1861667750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 001308-1) |
| Additional Taxonomies | 225200000X Physical Therapy Assistant (Licence: NY 000682-1) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2011-01-19 |