| NPI | 1235623711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: DT82257) | 
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT82257) | 
| Enumeration Date | 2018-06-19 | 
| Last Update Date | 2023-05-09 |