NPI | 1982124673 |
---|---|
Former Name | ELIZABETH PIERCE BUSTAMANTE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 174N00000X Lactation Consultant, Non-RN (Licence: AZ L-124887) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
Enumeration Date | 2017-06-22 |
Last Update Date | 2018-03-17 |