| NPI | 1699131284 |
|---|---|
| Former Name | MARISSA LEE GARCIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA 60827582) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CT 1201) |
| Enumeration Date | 2016-01-12 |
| Last Update Date | 2018-05-29 |