| NPI | 1396393997 |
|---|---|
| Former Name | KELSEY LYNN KOMISAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-08-28 |
| Last Update Date | 2022-08-24 |