NPI | 1871749341 |
---|---|
Former Name | JULIE JACKSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: MA 000002758) |
Enumeration Date | 2008-08-15 |
Last Update Date | 2012-04-04 |