| NPI | 1033404371 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: GA 896576) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: CA 896576) |
| 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: CA 896576) | |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: CA 896576) | |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2022-07-19 |