| NPI | 1063838589 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L003458) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: NC L003458) |
| Enumeration Date | 2014-03-07 |
| Last Update Date | 2014-03-12 |