| NPI | 1104312859 |
|---|---|
| Former Name | LISA GRANSKOG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MI 915921) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-08-30 |