NPI | 1487000279 |
---|---|
Former Name | LISA S SHAMBAUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA DN000007) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: PA DN000007) |
Enumeration Date | 2016-05-11 |
Last Update Date | 2018-09-17 |