| NPI | 1124450531 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINA SUZANNE ORTIZ Department Head, Clinical Dietitian 080-416-8704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: VA 964559) |
| Enumeration Date | 2013-08-08 |
| Last Update Date | 2013-08-08 |