Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | CH4552 | FL |
NPI | 1407061799 |
---|---|
Provider Name | David P Newman |
First Address | Miami, FL 33133-3957 |
Second Address | Miami, FL 33133-3957 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |