| NPI | 1255797536 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORYA A FOGEL Dietitian/Nutritionist 134-723-1583 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NY 005150-1) |
| Enumeration Date | 2016-01-03 |
| Last Update Date | 2016-01-03 |