| NPI | 1689919326 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA L MARTINE Member & Organizer 910-409-3996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L003743) |
| Enumeration Date | 2012-12-06 |
| Last Update Date | 2012-12-06 |