| NPI | 1033971395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: 86085019) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: WI 5160-29) |
| Enumeration Date | 2024-01-23 |
| Last Update Date | 2024-01-23 |