NPI | 1336483841 |
---|---|
Former Name | ANITA RAE CONLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: FL ND5649) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND5649) |
Enumeration Date | 2012-11-21 |
Last Update Date | 2019-06-04 |