| NPI | 1922606581 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VT 074-0134206) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: VT 86132977) |
| Enumeration Date | 2020-10-15 |
| Last Update Date | 2021-05-17 |