| NPI | 1902151442 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND6299) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: FL ND6299) |
| Enumeration Date | 2012-07-20 |
| Last Update Date | 2019-07-30 |