| NPI | 1053035980 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PA DN007328) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: PA DN007328) |
| 133VN1006X Dietitian, Registered, Nutrition, Metabolic (Licence: PA DN007328) | |
| 133VN1101X Dietitian, Registered, Nutrition, Gerontological (Licence: PA DN007328) | |
| 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: PA DN007328) | |
| Enumeration Date | 2022-10-04 |
| Last Update Date | 2022-10-04 |