| NPI | 1538100912 |
|---|---|
| Former Name | LISA J SPARCO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 171400000X Health & Wellness Coach |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2022-12-16 |