| NPI | 1134941099 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SIMEON MERTYL Director 862-346-5380 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management | 
| Enumeration Date | 2024-10-30 | 
| Last Update Date | 2024-10-30 |