NPI | 1992273346 |
---|---|
Former Name | KELLY ANN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OK 3084) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MN 4433) |
133V00000X Dietitian, Registered (Licence: OR D-10195067) | |
133V00000X Dietitian, Registered (Licence: VT 0740134470) | |
Enumeration Date | 2018-11-04 |
Last Update Date | 2025-03-10 |