| NPI | 1073851002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIESBETH GLENNA FERNANDEZ Registered Dietitian 810-908-5433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2013-01-25 |
| Last Update Date | 2013-01-25 |