| NPI | 1104215953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT07610) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NC L001495) |
| 133V00000X Dietitian, Registered (Licence: FL ND4912) | |
| 133V00000X Dietitian, Registered (Licence: OH 4318) | |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2015-01-16 |