| NPI | 1275243719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEEGAN J ZIEMBA Owner/Medical Director 757-630-2721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133V00000X Dietitian, Registered | |
| 208000000X Pediatrics | |
| Enumeration Date | 2022-11-23 |
| Last Update Date | 2023-06-06 |