NPI age
19 years
Enumerated 2007-04-03
Across 505 active dietitian, registered providers in Idaho.
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 8063175 | |
| 01 (ID) | 1447372453 | NATIONAL PROVIDER INFORMATION |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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