| NPI | 1730777020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIRABELLA MACIAS Registered Dietitian Nutritionist 575-640-2758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Enumeration Date | 2021-01-04 |
| Last Update Date | 2021-01-04 |