| NPI | 1649272659 |
|---|---|
| Former Name | GEORGIA A SCHREACKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164-000168) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MO 2004029301) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2011-08-17 |