| NPI | 1932491081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRIYANKA VARGHESE Director Of Operations 800-497-4917 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| 133N00000X Nutritionist | |
| Enumeration Date | 2011-05-09 |
| Last Update Date | 2011-05-09 |