Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 1256 | SD |
NPI | 1437560521 |
---|---|
Provider Name | Christine Duncan |
First Address | Sioux Falls, SD 57110-5737 |
Second Address | Sioux Falls, SD 57110-5737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2014 |
Last Update Date | 12/05/2014 |