NPI | 1033595855 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 133N00000X Nutritionist (Licence: MD DX3730) |
Additional Taxonomies | 133N00000X Nutritionist (Licence: DC NU100000171) |
Enumeration Date | 2015-08-04 |
Last Update Date | 2018-06-16 |