NPI | 1235824400 |
---|---|
Entity Type | Organization |
Authorized Contact | LAURA RUSSELL Owner 314-497-3367 |
Organization Subpart ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
Enumeration Date | 2023-04-05 |
Last Update Date | 2023-04-05 |