NPI | 1104289719 |
---|---|
Entity Type | Organization |
Authorized Contact | HANI MOHAMED ISSE President 612-227-7172 |
Organization Subpart ? | No |
Primary Taxonomy | 335G00000X Medical Foods Supplier (Licence: MN A552620000) |
Enumeration Date | 2016-03-31 |
Last Update Date | 2016-03-31 |