NPI | 1841740727 |
---|---|
Former Name | LARA TERESA GORDON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: OR 10178265) |
Enumeration Date | 2016-10-04 |
Last Update Date | 2016-10-07 |