| NPI | 1104122662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT05736) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT05736) |
| Enumeration Date | 2011-02-01 |
| Last Update Date | 2011-02-01 |