| NPI | 1962939769 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI60850685) | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164.007118) | 
| Enumeration Date | 2017-05-11 | 
| Last Update Date | 2019-03-26 |