| NPI | 1396160826 |
|---|---|
| Former Name | KELSAY MARY PETERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MN 1090652) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 3327) |
| Enumeration Date | 2014-02-20 |
| Last Update Date | 2023-11-21 |