| NPI | 1104921311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT00777) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT00777) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2012-01-05 |