| NPI | 1639860687 |
|---|---|
| Former Name | KATELYN HAGAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: SD 0753) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: ND 1286) |
| 133V00000X Dietitian, Registered (Licence: MN 4475) | |
| Enumeration Date | 2023-05-18 |
| Last Update Date | 2023-06-14 |