| NPI | 1003430794 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 133N00000X Nutritionist |
| 133NN1002X Nutritionist, Nutrition, Education | |
| 174H00000X Health Educator | |
| 246Z00000X Specialist/Technologist, Other | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-05-29 |
| Last Update Date | 2020-06-03 |