| NPI | 1790022234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE GUAN Registered Dietitian 305-277-5551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: AZ 1082914) |
| Enumeration Date | 2013-01-03 |
| Last Update Date | 2013-01-03 |