| NPI | 1861847857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: GA LD004959) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: GA AT002019) |
| Enumeration Date | 2016-04-27 |
| Last Update Date | 2019-09-09 |