NPI | 1114536380 |
---|---|
Former Name | SIERAH LAMAE PHILLIPS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: AZ 86104198) |
Additional Taxonomies | 133V00000X Dietitian, Registered |
133VN1004X Dietitian, Registered, Nutrition, Pediatric | |
2255A2300X Specialist/Technologist, Athletic Trainer | |
Enumeration Date | 2020-07-23 |
Last Update Date | 2024-11-19 |