| NPI | 1679984488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDAN COBURN Owner, Registered Dietitian 860-559-5178 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CT 03-696456) |
| Enumeration Date | 2014-05-14 |
| Last Update Date | 2014-09-02 |