| NPI | 1073181491 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 132700000X Dietary Manager (Licence: 339359) |
| Additional Taxonomies | 136A00000X Dietetic Technician, Registered (Licence: 86291705) |
| Enumeration Date | 2021-06-13 |
| Last Update Date | 2021-06-13 |