| NPI | 1760045793 |
|---|---|
| Former Name | MELODY SUE WILSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: OR LD-D000480) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2019-04-16 |