| NPI | 1033748124 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133VN1004X Dietitian, Registered, Nutrition, Pediatric (Licence: ID 86117056) |
| Additional Taxonomies | 133VN1301X Dietitian, Registered, Nutrition, Oncology (Licence: ID 86117056) |
| 133VN1401X Dietitian, Registered, Nutrition, Pediatric Critical Care (Licence: ID 86117056) | |
| Enumeration Date | 2020-04-02 |
| Last Update Date | 2020-04-02 |