| NPI | 1902358302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT84549) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: UT 10740267-4901) |
| Enumeration Date | 2016-11-01 |
| Last Update Date | 2019-09-09 |