| NPI | 1235637562 |
|---|---|
| Former Name | KACY ANN SHAFFER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MO 2018009252) |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| Enumeration Date | 2018-02-01 |
| Last Update Date | 2021-05-05 |