| NPI | 1275198459 |
|---|---|
| Former Name | KYLEE-JEAN WORMUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L005747) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: TX DT90018) |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2024-04-22 |