| NPI | 1023203676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT82462) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: MD DX2714) |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2021-04-06 |