| NPI | 1689206104 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT86398)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered | 
| Enumeration Date | 2020-02-12 | 
| Last Update Date | 2020-10-13 |