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Individual
HUNTER GREEN PLOG
Active
Individual
HUNTER GREEN PLOG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RD, LDN
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
D02221
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790748283
K3071638
MD
Enumeration date
04/07/2006
Last updated
01/16/2008
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