| 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 |