| NPI | 1104534304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT89982) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NE 1640) |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2025-06-19 |