| NPI | 1902090574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ME DI1048) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 006281) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2011-05-31 |