| NPI | 1093598559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE C OTUM Owner 832-859-5830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133N00000X Nutritionist |
| Enumeration Date | 2023-08-17 |
| Last Update Date | 2023-08-17 |