| NPI | 1558810796 |
|---|---|
| Former Name | NICOLE ISABEAU FAMULARO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT86643) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: VA 1079777) |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2021-06-28 |