| NPI | 1124477583 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER L HAGENDORF Registered Dietitian Nutritionist 210-320-0979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: TX DT80988) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |