| NPI | 1104583244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86144491) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT86424) |
| Enumeration Date | 2021-11-23 |
| Last Update Date | 2021-11-23 |