| NPI | 1851567705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY STAMATES ROERTY Owner 240-215-5084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: MD D01409) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-10-03 |