| NPI | 1376314120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROBERT MAHER Owner 631-875-0672 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1005X Dietitian, Registered, Nutrition, Renal |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2024-01-10 |