| NPI | 1861227852 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER GIBBONS COO 314-478-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic | |
| 133VN1501X Dietitian, Registered, Nutrition, Sports Dietetics | |
| Enumeration Date | 2024-09-07 |
| Last Update Date | 2024-09-07 |