| 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 |