| NPI | 1114156882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: PR 1385) |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education (Licence: PR 1385) |
| Enumeration Date | 2009-07-02 |
| Last Update Date | 2009-07-02 |