| NPI | 1417401993 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDYTA MARIA KONRAD Owner 508-460-6002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 157585) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2016-08-12 |
| Last Update Date | 2016-08-12 |