| NPI | 1770366049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BANTWAL SURESH BALIGA Md 706-718-9556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2023-09-28 |