| NPI | 1255585535 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT85290) | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2010002577) | 
| Enumeration Date | 2008-11-12 | 
| Last Update Date | 2019-12-13 |