| NPI | 1831771831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN MICHELLE BOWER COO 813-286-2033 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 170300000X Genetic Counselor, MS |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2023-05-10 |