| NPI | 1972876217 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VA 1002880)  | 
| Additional Taxonomies | 133N00000X Nutritionist (Licence: SC ldr893)  | 
| Enumeration Date | 2012-02-16 | 
| Last Update Date | 2013-03-11 |