ERVA SANTOSO

FORT BLISS, TX
NPI1962032045
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy133V00000X Dietitian, Registered
(Licence:   1072186)
Additional Taxonomies133V00000X Dietitian, Registered
(Licence: HI  205-LD)
Enumeration Date2020-01-17
Last Update Date2025-07-29
Business Address
ERVA SANTOSO RDN
18511 HIGHLANDER MEDICS ST
FORT BLISS, TX 79906-5327
Phone number: 718-360-7472
Mailing Address
ERVA SANTOSO RDN
11400 EDGEMERE BLVD APT 3113
EL PASO, TX 79936-2426
Phone number: 718-360-7472