| NPI | 1578380333 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM CISEK Registered Dietitian 702-813-4318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| Enumeration Date | 2024-09-23 |
| Last Update Date | 2024-09-23 |