| NPI | 1275152712 |
|---|---|
| Former Name | ELONNA MUNDALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 917940) |
| Additional Taxonomies | 174N00000X Lactation Consultant, Non-RN (Licence: 17067) |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-04-14 |