Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 38MC00183300 | NJ |
NPI | 1588925085 |
---|---|
Provider Name | Dr. William David Natusch |
First Address | Little Falls, NJ 07424-1247 |
Second Address | Little Falls, NJ 07424-1247 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2012 |
Last Update Date | 01/06/2012 |