| NPI | 1790029932 |
|---|---|
| Former Name | CHRISTA PETERSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NJ 1067475) |
| Additional Taxonomies | 136A00000X Dietetic Technician, Registered |
| Enumeration Date | 2012-11-10 |
| Last Update Date | 2020-10-01 |