| NPI | 1922153592 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY A GRUBB Administrator 813-977-5557 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: FL ND3503) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |