| NPI | 1902294168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 816548) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 000667-1) |
| Enumeration Date | 2014-12-22 |
| Last Update Date | 2023-02-22 |