| NPI | 1720371354 |
|---|---|
| Former Name | KRISTIN JO DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI60209738) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: OR 1042) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2016-01-05 |