| NPI | 1750649265 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: UT 278841-6004) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: UT 278841-4901) |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2016-03-16 |