| NPI | 1992917694 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OH LD.5999) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: OH AT000022) |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2015-07-17 |