| NPI | 1144525627 |
|---|---|
| Former Name | NANCY J GUSTAFSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ND 237) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: ND 237) |
| 133V00000X Dietitian, Registered (Licence: MN 3191) | |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: MN 3191) | |
| Enumeration Date | 2011-01-14 |
| Last Update Date | 2020-01-30 |