| NPI | 1821768649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIDRA S ELIA Organizer 248-595-2363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 261Q00000X |
| Enumeration Date | 2021-09-14 |
| Last Update Date | 2021-09-14 |