| NPI | 1013514017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist |
| Additional Taxonomies | 133NN1002X Nutritionist Nutrition, Education |
| 174H00000X Health Educator | |
| Enumeration Date | 2020-10-03 |
| Last Update Date | 2020-10-03 |