| NPI | 1053672188 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT07342) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MA 3308) |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2014-05-08 |