| NPI | 1407375587 |
|---|---|
| Former Name | JENNA P TALLAKSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NM LD-1148) |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: NM LD-1148) |
| Enumeration Date | 2017-09-11 |
| Last Update Date | 2017-09-11 |