| NPI | 1487905261 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN AARON KOTLER Program Manager 410-409-6992 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD DX2666) |
| Enumeration Date | 2012-09-20 |
| Last Update Date | 2012-09-20 |