| NPI | 1104589894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR 10229291) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT89779) |
| Enumeration Date | 2021-10-19 |
| Last Update Date | 2025-03-05 |