| NPI | 1780924464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered Nutrition, Pediatric (Licence: TX DT83196) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IA 002091) |
| 133V00000X Dietitian, Registered (Licence: WI 2564-29) | |
| Enumeration Date | 2013-02-18 |
| Last Update Date | 2015-12-28 |