NPI | 1720882335 |
---|---|
Former Name | SHELLEY LYNN MUNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MO 2001018096) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: KS 516) |
Enumeration Date | 2025-04-02 |
Last Update Date | 2025-04-02 |