| NPI | 1124397062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LYNN BOLLMAN President 917-680-2820 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: OR LDD10144515) |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2011-12-21 |