| NPI | 1891218772 |
|---|---|
| Former Name | SAMANTHA JOAN SANDOVAL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 86097273) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2019-10-08 |