| NPI | 1962536276 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L002902) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ADA #724152) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |