| NPI | 1760793020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT81561) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT81561) |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2021-05-11 |