| NPI | 1104467760 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133N00000X Nutritionist (Licence: IL 164.007859) |
| Additional Taxonomies | 175F00000X Naturopath (Licence: VT 099.0134102) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2020-02-24 |