| NPI | 1811612039 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT87779) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TN 5339) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2025-10-31 |