| NPI | 1467987719 |
|---|---|
| Former Name | CRYSTAL MARDIN KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AK 199721) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NY 008971-1) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2023-10-06 |