| NPI | 1710262753 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 931691)  | 
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DTO7672)  | 
| Enumeration Date | 2011-10-20 | 
| Last Update Date | 2011-10-20 |