| NPI | 1912573247 |
|---|---|
| Former Name | JACLYN ROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: CT 2532) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX5237) |
| Enumeration Date | 2021-05-27 |
| Last Update Date | 2025-01-08 |