| NPI | 1124787783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT84495) | 
| Additional Taxonomies | 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics (Licence: TX DT84495) | 
| Enumeration Date | 2021-12-10 | 
| Last Update Date | 2021-12-10 |