| NPI | 1073241675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: AZ 86172466) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: 86172466) |
| Enumeration Date | 2022-08-11 |
| Last Update Date | 2023-09-01 |