| NPI | 1245907401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ALICIA MIRANDA Dietitian 915-243-2370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-08-25 |
| Last Update Date | 2022-11-08 |