NPI | 1376048801 |
---|---|
Former Name | ANDREA LYNN SUJKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: 949739) |
Enumeration Date | 2018-03-27 |
Last Update Date | 2018-03-27 |