| NPI | 1194165464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA11956) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2018-04-02 |