NPI | 1013683267 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: CA 876319) |
Additional Taxonomies | 133VN1004X Dietitian, Registered, Nutrition, Pediatric |
Enumeration Date | 2021-08-18 |
Last Update Date | 2021-10-19 |