| NPI | 1962554972 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI60455187) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 2624) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-09-23 |