| NPI | 1265916167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT85560) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2023-08-07 |