| NPI | 1881998128 |
|---|---|
| Former Name | GWENDOLYN NISSLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA DN007411) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 000747-1) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2021-07-14 |