| NPI | 1114709573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY BENTO Registered Dietitian 208-954-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Enumeration Date | 2023-10-19 |
| Last Update Date | 2023-10-19 |