| NPI | 1033497425 |
|---|---|
| Former Name | LACEY BURRELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WY 211) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: SD 0410) |
| Enumeration Date | 2011-08-02 |
| Last Update Date | 2018-12-20 |