NPI | 1811536485 |
---|---|
Former Name | TEALE GREENWOOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: WA DI61023024) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
Enumeration Date | 2019-12-31 |
Last Update Date | 2020-01-24 |