| NPI | 1588858039 |
|---|---|
| Former Name | KELLY L MCCORMICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: MN 1690) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2012-11-30 |