NPI | 1619675147 |
---|---|
Former Name | MEGAN JANEEN PETERSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 954519) |
Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 2079-79) |
Enumeration Date | 2023-02-23 |
Last Update Date | 2023-02-23 |