| NPI | 1104304567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: LA 3150) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT85082) |
| Enumeration Date | 2018-07-29 |
| Last Update Date | 2023-03-24 |