| NPI | 1962789503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: KY 2368) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 1128985) |
| Enumeration Date | 2011-11-10 |
| Last Update Date | 2011-11-10 |