NPI | 1639542665 |
---|---|
Former Name | BETHANY MICHELLE MOTES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: SC 1685) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD004464) |
Enumeration Date | 2015-11-13 |
Last Update Date | 2018-03-21 |