| NPI | 1780891564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: TX DT06597) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 106-22905) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-07-08 |