| NPI | 1962772004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NE 1477) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IA 099226) |
| Enumeration Date | 2012-01-06 |
| Last Update Date | 2021-05-03 |