| NPI | 1841011889 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT89191) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX 86299418) |
| Enumeration Date | 2024-10-22 |
| Last Update Date | 2024-10-22 |