| NPI | 1144572272 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT82602) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX 01100111) |
| Enumeration Date | 2012-10-13 |
| Last Update Date | 2021-04-19 |