| NPI | 1174828206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT4158) |
| Additional Taxonomies | 225700000X Massage Therapist (Licence: TX MT40972) |
| Enumeration Date | 2011-01-20 |
| Last Update Date | 2011-01-20 |