Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 8408 | TX |
NPI | 1043540891 |
---|---|
Provider Name | Dr. Ritamarie Loscalzo |
First Address | Austin, TX 78730-2711 |
Second Address | Austin, TX 78730-2711 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2009 |
Last Update Date | 29/12/2009 |