NPI | 1043541584 |
---|---|
Former Name | DAKOTA ALLSTADT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: UT 8668423-1206) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 1036816) |
Enumeration Date | 2010-01-22 |
Last Update Date | 2019-11-26 |