Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 001620 | CT |
NPI | 1275751273 |
---|---|
Provider Name | Dr. Lori Estelle Breiner |
First Address | Westport, CT 06880-4328 |
Second Address | Westport, CT 06880-4328 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 09/04/2017 |