| NPI | 1295092229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE MAIDENBERG Medical Doctor 626-797-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 132700000X Dietary Manager (Licence: NY R049213-1) |
| Enumeration Date | 2012-04-16 |
| Last Update Date | 2012-04-16 |