| NPI | 1780142539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA20092) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT84477) |
| 133V00000X Dietitian, Registered (Licence: TX DT84477) | |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2026-05-08 |