| NPI | 1114585197 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: NC L006673) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: 86070709) |
| 133V00000X Dietitian, Registered (Licence: 86070709) | |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2023-05-31 |