| NPI | 1912442682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: WY 283) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WY 283) |
| Enumeration Date | 2017-01-04 |
| Last Update Date | 2019-10-28 |