| NPI | 1811581705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDRA NICOLETTE Registered Dietitian Nutritionist 315-351-2622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |