| NPI | 1164835971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX BP10078990) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2014-06-09 |
| Last Update Date | 2026-08-20 |