NPI | 1659754810 |
---|---|
Former Name | SHANNON LEIAMBRE MORGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: ID D-874) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: ID D-874) |
Enumeration Date | 2015-07-07 |
Last Update Date | 2019-07-25 |