| NPI | 1477064863 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANITA W. GATHOGO Owner 443-776-8429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX22478) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: MD DX2478) |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-04-22 |