| NPI | 1124672654 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IN 37003128A) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: IL 164.007751) |
| Enumeration Date | 2019-08-01 |
| Last Update Date | 2021-10-12 |