NPI | 1609111640 |
---|---|
Former Name | KIMBERLY R GREEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CO 1020228) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: NM LD-0824) |
Enumeration Date | 2012-12-03 |
Last Update Date | 2016-12-27 |