| NPI | 1477233625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARQUITA DANIEL Trichologist 219-595-0566 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| Enumeration Date | 2023-07-24 |
| Last Update Date | 2023-07-24 |