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Individual

ANZOR MODZGVRESCHVILI

Active
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Individual

ANZOR MODZGVRESCHVILI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RD

Taxonomy

Speciality
Code
Description
License number
State
133VN1101X
Gerontological Nutrition Registered Dietitian
Primary
C05672
MD
133VN1101X
Gerontological Nutrition Registered Dietitian
—
NULL

Other

Enumeration date
03/15/2020
Last updated
09/20/2022
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