NPI | 1962103416 |
---|---|
Former Name | KATELYN MCKENZIE CONNICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133VN1501X Dietitian, Registered Nutrition, Sports Dietetics (Licence: KS 86020609) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IA 119181) |
133V00000X Dietitian, Registered (Licence: KS 2423) | |
133V00000X Dietitian, Registered (Licence: MO 2023012539) | |
Enumeration Date | 2023-03-13 |
Last Update Date | 2023-04-08 |