NPI | 1962128140 |
---|---|
Former Name | STEPHANIE N ANDERSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: OR LD-D-10226577) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
Enumeration Date | 2022-10-18 |
Last Update Date | 2023-04-21 |