| NPI | 1972902039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 3461) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IA 074875) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2016-10-12 |