| NPI | 1134364029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: IL 164.004841) |
| Additional Taxonomies | 133V00000X Dietitian, Registered (Licence: GA LD003265) |
| Enumeration Date | 2008-12-08 |
| Last Update Date | 2008-12-08 |