| NPI | 1033402003 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: RI LDN00553) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: FL ND11059) |
| 133V00000X Dietitian, Registered (Licence: MA 2246) | |
| Enumeration Date | 2011-05-24 |
| Last Update Date | 2023-03-15 |