NPI | 1689608523 |
---|---|
Former Name | LAURA CHRISTINE BUKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 3055) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
133V00000X Dietitian, Registered (Licence: ND 763) | |
Enumeration Date | 2006-07-10 |
Last Update Date | 2013-03-15 |