| NPI | 1053811638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NOELLE MARIE DESANTIS Registered Dietitian 716-417-6388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: NY 009292) |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2018-02-20 |