| NPI | 1932846219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN GOODMAN Registered Dietitian 410-686-0459 |
| Organization Subpart ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2022-05-17 |
| Last Update Date | 2025-02-05 |