| NPI | 1982567392 |
|---|---|
| Former Name | CARISSA WEIBERG |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2025-12-03 |
| Last Update Date | 2025-12-03 |