NPI | 1104391424 |
---|---|
Former Name | KIMBERLY JO ADOLFSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID D-522) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: ID D-522) |
133VN1005X Dietitian, Registered, Nutrition, Renal (Licence: ID D-522) | |
133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: ID D-522) | |
Enumeration Date | 2018-10-13 |
Last Update Date | 2018-12-18 |