| NPI | 1720523715 |
|---|---|
| Former Name | TEDDY ANN COSTA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CO 1024756) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NM LD0955) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2017-11-06 |