Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 8034 | TX |
NPI | 1083891022 |
---|---|
Provider Name | Dr. Gordana Djumic |
First Address | Plano, TX 75025-4580 |
Second Address | Plano, TX 75093-3927 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2008 |
Last Update Date | 22/01/2008 |